Department of Urology, Shanghai Changhai Hospital, the Second Military Medical University, 168 Changhai Road, Yangpu District, Shanghai, 200433, China.
World J Urol. 2020 Apr;38(4):853-858. doi: 10.1007/s00345-019-02868-7. Epub 2019 Jul 10.
To evaluate the feasibility and safety of the application of robotic enucleation of adrenal masses (REAM).
Thirteen patients at Shanghai Changhai Hospital who underwent robotic enucleation of adrenal mass from February 2017 to March 2018 were reviewed. After mobilizing the adrenal gland and clamping the feeding blood vessels, the tumor was enucleated and reconstruction was performed. Relevant clinical data were recorded including baseline patient and tumor characteristics, and perioperative outcomes (operating time, ischemic time, estimated blood loss, complications, and so on).
All cases were successfully completed without conversion to total adrenalectomy or open surgery. The mean operative time was 75 min (range 60-95), with a mean warm ischemia time of 12 min (range 8-17). The estimated blood loss was 20 mL (range 10-50). No intraoperative complications were observed, and no steroid replacement was given post-operatively. After a median follow-up period of 12 months (range 9-15), no evidence of disease recurrence was detected.
Robotic enucleation of adrenal masses is a safe and feasible procedure with excellent short-term functional and oncologic outcomes. Steroid supplementation is not necessary and recurrence is not usual with limited follow-up. Long-term follow-up and larger studies should be conducted to further evaluate outcomes of this robotic adrenal-sparing approach.
评估机器人肾上腺肿瘤剜除术（REAM）的可行性和安全性。
回顾 2017 年 2 月至 2018 年 3 月在上海长海医院接受机器人肾上腺肿瘤剜除术的 13 例患者。在移动肾上腺并夹闭供血血管后，剜除肿瘤并进行重建。记录相关临床数据，包括基线患者和肿瘤特征以及围手术期结果（手术时间、缺血时间、估计失血量、并发症等）。
所有病例均成功完成，无一例转为全肾上腺切除术或开放手术。平均手术时间为 75 分钟（范围 60-95 分钟），平均热缺血时间为 12 分钟（范围 8-17 分钟）。估计失血量为 20 毫升（范围 10-50 毫升）。术中未观察到并发症，术后无需给予类固醇替代治疗。中位随访 12 个月（范围 9-15 个月）后，未发现疾病复发的证据。
机器人肾上腺肿瘤剜除术是一种安全可行的手术方法，具有良好的短期功能和肿瘤学结果。无需补充类固醇，且在有限的随访中复发并不常见。需要进行长期随访和更大规模的研究，以进一步评估这种机器人保留肾上腺的方法的结果。
